Bullying And Psychiatric Illness Linked

I'm Michel Martin and this is TELL ME MORE from NPR News. They say it takes a village to raise a child, but maybe you just need a few moms in your corner. Every week, we check in with a diverse group of parents for their common sense and savvy advice.

Today, we want to return to an issue that's been a part of childhood for decades, if not forever, but which has lately become the subject of much national concern. We're talking again about bullying, and we're talking about it because parents, educators and policymakers have become aware of just how traumatic bullying can be for young people.

Now, though, a new study shows that these damaging effects can follow people to adulthood. The new study published last week in the Journal of the American Medical Association's JAMA Psychiatry followed almost 1,500 children and found both victims and perpetrators of bullying had higher rates of psychiatric disorders as adults.

We wanted to talk more about this, so we're joined now by the study's lead author, William Copeland. He's an associate professor of psychiatry at Duke Medical Center. He's also a dad of two.

And we also called Rosalind Wiseman. She's the author of several books, including the best-selling "Queen Bees and Wannabes." That book actually inspired the hit movie, "Mean Girls," and she's the mom of two boys, also.

Thank you so much for joining us, both of you.

ROSALIND WISEMAN: Thanks for having me.

WILLIAM COPELAND: Good to be here.

MARTIN: Professor Coleman, I want to focus on the long-term effects, but one of the things that I wanted to point out that was interesting about your research is that you studied both bullies and victims and this might surprise some people, but you studied people who were both bullies and victims. Why is this important?

COPELAND: Yeah. Well, we really wanted to kind of get the full range of behavior and so, actually, we studied a representative group of kids and followed them up over time, so there's a fair bit of the sample that actually wasn't involved in bullying at all.

But I think, in order to really understand the long-term consequences of bullying, you really have to get at kind of both sides of this, because there's also a substantial group of kids that are both victims of bullying and bullies themselves. And in our study, they had the worst long-term outcomes.

MARTIN: I want to talk about that, but let's tease out a couple of these things. You found that children who are bullied are four times more likely to have an anxiety disorder as a young adult, compared with people who were not bullied. Now, that might not surprise some people, but you've found, as you just said, that people who both bullied other kids and were victims fared even worse. They were 14 times more likely to develop panic disorders as adults. Now, why might that be?

COPELAND: Well, it seems like these kids really have the worst lot and a lot of this may have to do with the type of kids that end up being kind of bully victims. So I think, typically, we think of these kids as kind of having difficulty, socially, to begin with, in school. And that may be one of the reasons that they get picked on. And they see the only way to kind of escape this, to escape getting picked on and to have some sort of, you know, social status is to kind of lash out at others. So these may be kids that are maybe a little bit more impulsive, a little bit more aggressive. And so, whereas a lot of people, if they're bullied, they might think, oh, this really hurts. I don't like this. I definitely don't want to do this to other people - these are kids where this really seems to be the only option for them and, obviously, this doesn't bode well for their future development.

MARTIN: Are you surprised that the effects last as long as they seem to?

COPELAND: I was. And, in fact, this study kind of came about because I was talking with one of my colleagues or, actually, I had somebody ask a question at a presentation and he asked us if we were paying attention to bullying. And I wasn't sure that this was going to actually be something that caused problems, you know, a decade down the road after the kids had, kind of, moved out of school and were now adults.

And so we, kind of, started this collaboration to see what would happen. And I think the results were as striking to me as they were to anyone that the victims, you know, really had these long-term emotional problems, particularly with anxiety, but then this kind of small group of bullied victims had depression, suicidality, anxiety. And this is over 10 years after we kind of first started studying them in childhood.

MARTIN: Rosalind Wiseman, one of the reasons we're glad you were able to join us is that I think a lot of people might be familiar with your work. If they're not familiar with any of the academic work, they might have read one of your books.

Are you surprised by this? What do you make of this?

WISEMAN: Oh, my gosh. I'm not surprised at all. I'm just so grateful that they did the study, because, so often, what happens is we talk about these things in extremes, like the kid who only is victimized or the kid who only bullies. And what we know, if you work in schools, is that this is a much more complex issue. And so the emphasis on the bully victim is so helpful to the discussion, the real discussion that we need to have to be able to help kids.

And so what I look at when I teach children is about the ease in which they're manipulated, sometimes, by other kids or that they react much more strongly than other children to what they see as perceived slights and that they need to do something about it and be aggressive, or that they are victimized by it.

And many, many parents, when their children get involved in these issues, they feel that their children are the victims. And they never think that part of this could be that their child is retaliating or doing something that contributes to the problem. And that's not about blaming the target. It's about understanding the dynamics so we can get to a place where we address it more effectively.

MARTIN: Roz, I wanted to ask you why do you think it is that the long-term effects of this have not really a part of the national conversation? I mean obviously, there have been a number of, you know, terrible tragedies where - not just in this country interestingly enough but in other countries where children have taken their own lives after having been bullied. But what happens later on in adult life, it doesn't seem to be something we talk about. Why do you think that is?

WISEMAN: Because I don't think we like to think about our own behavior as adults. I think we like to look at kids and their problems and then not think about how it impacts us systemically and individually. It is very clear to me that people's anxiety and people's - when we think about you're dealing with a parent who immediately goes from a small problem to an enormous problem and reacts so strongly and disproportionately to whatever it is that's in front of them. How did we get to this place? I mean if you work - if you're a teacher or a coach, you pretty much are going to have that experience when you're working with a parent, where you think wait a minute, what is going on that this has become such an incredible - that I'm being treated this badly and that I'm being bullied? That's not an uncommon experience, or that a parent has that about another parent or a teacher. We don't like to - we have a hard time thinking about our own experiences and the legacy that we bring as children.

And so what we talk about anxiety and about thinking that we are justified in going after other people to right a wrong, and this is one of the big challenges in parenting is that when you think that somebody has done something wrong to your child, you get to a place where you think you have a higher purpose or higher calling to go after that person, and that you don't have to treat them well, you don't need to treat them with dignity, you actually have the right to bully that person back. And that's really a problem and we've got to be able to look at that. And I would hope that this kind of a study would give us an opportunity to look at our own behavior.

MARTIN: I'm joined by best-selling author Rosalind Wiseman. That's who was speaking just now. I'm also speaking with the author of a study about the long-term effects of bullying. That's Professor William Copeland of Duke University.

Professor Copeland, one of the other staggering numbers you found is that boys who were, as you call them, bully victims, they were both bullied and they bullied other kids, is that they were 18 times more likely to have suicidal thoughts as adults compared with those who were not bullies or victims. What did you observe in this group? Why do you think that is?

COPELAND: Well, this was really one of the most striking findings that we had, that these kids were still at such risk way down the road. And one of the things we really wanted to kind of clarify in this study was that, you know, this risk was really related to their involvement in bullying. So we'd studied these kids extensively in childhood and were able to count for so much about their functioning in childhood and their family setting and their exposure to maltreatment and so on and so forth. But it really allowed us to just focus in on the long-term effects of being both a bully and a victim. And for those boys in particular, you know, the finding that there were such increased risk for suicidality, was really concerning.

There's another thing that I just want to add kind of getting back to that last question about kind of what, you know, this means, and I think it's common, you know, certainly for myself as a clinical psychologist by training, but in society in general, that we think of a lot of the things that affect children the most as the things that happened within the home, and what is their relationship like with their parents and how are they treated, and are they mistreated? And these are the things that are going to affect them most emotionally long-term. And those things are obviously so important and we need to kind of continue to pay attention to them. But I think we often forget that kids spend as much time or more time at certain ages in the school setting and with their peers. And now with the Internet as well, a lot of kids are interacting with their peers when they're at home - maybe even when they're supposed to be interacting with their parents. So the idea that these kind of experiences, like bullying and being a victim, can affect them so profoundly long-term, perhaps shouldn't be as surprising as it is to us.

MARTIN: I do have to ask about that though, Professor Copeland, because at this point I'm guessing some people might say how do you know it's the bullying? How do you know what's going on at school as opposed to number one, underlying psychological issues that may lead the kid to be either a target or victim, right, or both...

COPELAND: Right.

MARTIN: ...or the stuff going on, you know, at home because unfortunately, you found a number of these incidents where a child acts out of school and then you find out that there's something terrible going on at home. How do you know it's what's going on at school as opposed to those other factors?

COPELAND: Well, it's absolutely the case that kids that are victimized at school are often, you know, having challenges at home too. And it could be that they're also being bullied at home, maybe by other peers - by their siblings and, of course, that's much worse for them if there is that kind of no escape from it in any setting. But the reason that we're so certain that what we're observing here is the long-term effects of being bullied and being a victim, is because we studied these kids. We've been studying these kids for 20 years, and when they were children, we we're asking them about their emotional functioning, and we're asking their parents about their home life and how they were parenting the child.

So these are all things that we could account for in our models and trying to predict these long-term behaviors. So we were really able to, you know, separate out and look at the independent effect of being bullied, and that's why we're so confident that what we're observing here are really the long-term effects of that kind of peer victimization and peer harassment. That's not to say that those other things don't play an important role in how a child responds to bullying and maybe how they do long-term. But at least in this case it really feels like it's the bully victimization and then also then kind of being a bully, which is affecting their long-term emotional functioning.

MARTIN: On the other side of it though, why is it that kids who are bullies - I think people can understand gee, if you were bullied you could understand why you'd carry that with you. But I think a lot of people might still be struggling with the idea that if you are the bully or both, why you're carrying that with you too. I'm thinking - and you say this actually in the introduction to the study that - I think for most people you sort of think well, the long-term affect of being the bully is you probably wind up being an offender, right? But you're saying it's way beyond that. Why? Why might that be?

COPELAND: Well, yeah. It's much more complex than that. You know, we had the three groups here. We had kind of peer victims. We had kids that were both victims and then also bullied others. But then we also had a group of kids that just bullied other kids. It was about five percent of the sample. And these kids did not necessarily have long-term emotional problems, but they had other kinds of problems which suggest that as adults they're continuing to mistreat those around them.

And I have to say, you know, the more that I've been talking to people in the last week, the more you realize bullying isn't something that ends with childhood either. I mean this is something that goes on at work and in all sorts of areas of life, certainly into adulthood. But the kids that are just bullies don't necessarily seem to have the emotional problems themselves. It's these kids that are both picked on but then also kind of see bullying as a way to kind of, you know, achieve some sort of power, success or social status in schools. And that's that target group that we really need to be, you know, getting at and treating and addressing these concerns or else we're going to have the kind of problems that we identified in the study.

MARTIN: Roz Wiseman, I know that you're just hearing this for the first time or just acquainting yourself with this research.

WISEMAN: Mm-hmm.

MARTIN: But as a person who spends a lot of time in schools and working with kids while they're in school and out of school, what does this suggest for you? Are there some things that suggest for you about the way we think about bullying and schools might need to change?

WISEMAN: Absolutely. I would love for people to see this as a more dynamic, complex situation. And that, you know, boys and girls who are perpetrators and targets, that - or bullies and victims - that if we understand that they are in the mix of this in both ways, then the way in which we discipline and address the problems can be much more effective. Because I'll give you a, you know, really easy, I think, way of hopefully an easy way out of seeing this. I always tell teachers you always see the second hit. You never see the first hit, which means that the kid who is lashing out probably has less social skills and is more reactive. And that the kid who probably is defined as that five percent that we were just talking about, if they have high social skills and are able to push, right, and be mean to somebody, but the other person that they're doing it to reacts and then they're the one that gets in trouble by the teacher because that's what the teacher sees, then they are disciplining ineffectively. In fact, it's so counterproductive because it looks like - and it really does look like - that the teacher is disciplining the kid who was just reacting. They actually aren't addressing the problem that started it.

And so if we have those kinds of responses, and unfortunately we do way too often in schools and in our own homes, then what we do is we never get to the root of the problem. And so that the kid who started it actually is emboldened and the child who gets in trouble is resentful and angry and understands or believes the adults cannot help them and don't see this and are part of the problem. And so many of our disciplinary responses in schools are about that. So if we can understand the complexity of the problem then we are going to go a long way to not only addressing it more effectively, but being more credible to kids. And when we're more credible to kids, then they feel like they can calm themselves down and feel like they can come to us for support and think through the problem. Otherwise, they're just going to keep reacting.

MARTIN: Professor Copeland, final thought from you?

COPELAND: Well, I think one of the things that that means to me is that we really need to be talking about this a lot more. And parents need to be asking their kids as just a matter of course, how are things going at school? How are you getting along with other kids? Is anybody giving you a hard time? So that they actually, you know, have some sense of what's going on in their child's, you know, peer life and so then they can kind of collect more information, maybe problem solve with the child, and in some cases may be even bring it to the attention of school officials.

MARTIN: William Copeland is an associate professor of psychiatry at Duke University. He was kind enough to join us from the studios at the campus there. Rosalind Wiseman is the author - among other books - of the best-seller "Queen Bees and Wannabes." She was with us from Boulder, Colorado.

Thank you both so much for speaking with us today.

WISEMAN: Thanks.

COPELAND: Thank you.

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MARTIN: And now we invite you to tell us more. Every Tuesday, we turn to parents for their savvy advice. But next week, we want to turn the tables and talk about the growing number of people choosing not to become parents. If you've decided to go child-free, we'd like to hear more about it. Visit us online at npr.org/TELL ME MORE. Please remember to leave us your name or look for us on Twitter@TELLMEMORENPR.

And that's our program for today. I'm Michel Martin and you've been listening to TELL ME MORE from NPR News. Let's talk more tomorrow.